Is this a gallbladder issue?

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Hi, I had my bowel removed three years ago and now have a Jpouch (this is formed from the small intestine and I go to the toilet through the rectum as per normal) I have had a number of issues with burning rectal pain and anal ulcers and have been on a bland diet of potoato, rice, bread, soup and eggs etc for a couple of months before I realised that I was still passing yellow greasy dirarrhoea, which seemed impossible with no fat in my diet!  I also have excessive gas (belching) acid indigestion and I am finding I am very breathless at times as well.

I am under a GI surgeon who cannot understand the intense rectal pain as I only have mild inflammation in the rectum.  I find when he gives me ciproxin it helps with the greasy stool and a little with the pain, but I have only just mentioned to him the fact that I think I may have some gallbladder issues, so he is doing an ultrasound on Monday.

Does any of this sound familiar, I have no chest pain but a feel this may be a gallbladder problem. This has been going on for over a year and I just wondered if anyone had experienced anything similar??

Thanks so much.

Bernie

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35 Replies

  • Posted

    Hi Bernie,

    Sorry to hear you're having these difficulties.  Seems to me that you've already been through a lot!

    If the liquid surrounding your stools is clear and yellow, it's bile. When a gallbladder is diseased it's either releasing too much bile during digestion, which results in diarrhea, or too little, which results in constipation.  Bile is an acid, and extremely caustic, which would explain why you're experiencing pain.

    Besides an ultrasound, your doctor might want to do blood tests to determine whether your liver and/or your pancreas are stressed, which is also a by product of gallbladder disease.  

    Bile is released into the small intestine during digestion.  The body also produces a hormone which allows the bile to be reabsorbed during the digestive process.  Perhaps your body is no longer producing this hormone.

    Finally, sometimes an ultrasound will not show when a person has small gallstones or sludge in the gallbladder.  A CT scan usually works better, but not always.

    Best of luck to you, and please let me know how you get on!

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    • Posted

      Thanks so much for your reply Lynda, I know pretty much everything there is to know about pouuches but not much about gallbladders I'm afraid!!!  

      I have been on antibiotics for over a week now and this has helped with the bile, it tends to be green now but goes back to yellow if I eat any sort of fat content.

      At the moment I really hope it is my gallbladder (mad I know!) as if they cannot figure out what is casuing the pain then they will remove the rectum and I will have to go back to an illeostomy and there is noting wrong with my pouch so that would be a real shame.

      If it is just inflammation would that show on an ultrasound do you think?  When he removed my colon, he had a lot of trouble as it was stuck to me duodenum, I wonder if this could be relevant??

      Yesterday I had a weird thing happen..I couldn't breath and my heart was racing (I was only walking down the road) could this be related to gallbladder issues or do you think it could just be the strain of the pain or even the painkillers I am taking? (naproxin and co-codamol)

      Sorry for all the questions but you seem to know a lot about this and I want to be able to go to see my consultank on Thursday with some knowledge and I will ask him about bloods if they don't do any.

      Many thanks

      Bernie

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    • Posted

      Hi Bernie,

      I'm in the US, so there will probably be a bit of a delay in my responses.

      From what you are saying it seems to me that you might have an infected gallbladder.  Inflammation won't show on an ultrasound, but what might show up is thickening of the gallbladder walls. If you have an infection, your white count will be elevated. Also, gallbladder problems can stress your liver and your pancreas.   

      You should also know that naproxin is very irritating to your digestive tract. In fact, I suggest that you research the drugs you are taking on line and pay particular attention to the side effects.

      Finally, taking antibiotics can mess up the bacteria in your digestive system and lead to a build up of harmful bacteria that are normally kept at bay by the good bacteria.  I'm not necessarily advocating that you take probiotics, but you could ask your doctor about it.  Even if you can eat yogurt that might help in the long run.  You need good bacteria to populate your digestive tract.

      Your body is particularly stressed by your medical conditiona and the drugs you are taking, so I think that what you suffered is your body telling you to take it easy...   

      Please let me know how you get on! 

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    • Posted

      Thanks Lynda, I will look them up, I know naproxin can cause stomach bleeds, but when I stop taking them the anal pain gets so much worse...I have only been on the antibiotics for a week, as they just take the edge off the burning pain I get, I presume they are not the antibiotics which would be used for and infected gallbladder but they were given to treat bactieria in the rectum, this was before I suspected I may have gallbladder issues.

      I'll speak to my doctor about all you have mentioned about the drugs and see what he says about probiotics...mind you he's a surgeon and they don't tend to offer much in the way of dietary advise smile I will start on the yoghurts though...I should have thought of that!

      I am at my whits end with pain I am in all the time and it would be such a travesty to have to go back to an ileostomy when there is nothing worng with my pouch!!!

      Thanks so much for taking the time to give me advice, it really has helped. 

       

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    • Posted

      I'm glad to know I've helped.  So, what antibiotics are you on, may I ask?  

      I agree that it would be a shame to have to go back to your ileostomy!  

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    • Posted

      Ciproxin, which is for bacterial infection, this is what he gives me for the inflammation in the rectum.
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    • Posted

      Okay, so that's cipro, correct?  I am wondering, because cipro tends to wipe out "good" bacteria as well as the "bad."  

      Probiotics might help you restore a healthy balance and lead to fewer overgrowths of the bad stuff.

      Just a thought!  Hope you start feeling better!  

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    • Posted

      Yeah I think it is cipro, in teh UK it called ciproxin but I'm sure it's the same.  That's intersting....I'll give probiotics a go then.

      Thanks again.

      Bernie

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    • Posted

      You're welcome.  One more thing.  Make sure that you get bacterial cultures that work in your urinary tract and your gastrointestinal tract.  They also need to be able to survive the acid in your stomach.  

      I suggest that you mention this to your doctor, too.  

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    • Posted

      I will, thanks Lynda...funny you mention urinary tract, I seem to be needing to pass water a lot more than usual, but didn't think anything of it.

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    • Posted

      As people age they tend to become dehydrated quickly, so drinking lots of water is important.  Sometimes, they also get urinary tract infections but don't have any pain, which can mean that the infection can move into the kidneys.  

      This makes urinary tract infections in the elderly very serious, because none of the typical symptoms are present.  I recently had a UTI, but I started experiencing the symptoms of frequent urination one month prior to the time that I developed pain. So I have to be very careful from now on...

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    • Posted

      I have to drink a lot of water due to having no colon...and I am getting on a bit now, i'm 59, so I need to keep a better eye on everything I think!!!

      Are you a doctor or nurse by the way?

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    • Posted

      No, I'm not in the medical profession.  Everything I've learned can be traced to research and the school of hard knocks! smile

      Please do let me know how you get on with your doctor!  

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    • Posted

      Well you could have fooled me biggrin  I know what you mean, experience is a great eductaion!!!

      I'll let you know how I get on.

      Thanks again.

      Bernie

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    • Posted

      Hi Lynda,

      I had my ultrasound today and the radiographer said there were no stones but there was some sludge in the gallbladder, though he's not sure there is enough to casue this much of a problem.  He asked if my surgeon had done any stool tests, which he hasn't and said he may well want to do that now.

      He also said I have a cyst in my kidney, actually one in each, which he said is not unusual, but one of them will need another scan apparently. He did say why but I can't remember the word he used!!!

      I started on yoghurts today...hopefully they will help.

       

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    • Posted

      Hi Bernie!

      Well, anytime there's sludge in the gallbladder it can become irritated and have difficulty doing its job. From my own experience, if stool tests are done, they may come back as "normal" because they're testing only the stool, not the yellow or green liquid that surrounds them.  That happened to me. I had my stools tested twice and they came back as normal.

      They need to do bloodwork and test the levels of enzymes secreted by your liver and pancreas.  Those tests will indicate whether those organs are stressed--a sign of gallbladder disease.

      I hope that the yogurt helps you, too!

      Have a good day.

      Lynda

       

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    • Posted

      If he doesn't offer bloods I will ask for them on Thursday when I see him.

      What was your experience then, was it similar in that nothing obvious was showing but you actually did have problems??

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    • Posted

      Ask him to do a panel to check the liver/pancreatic enzymes.  

      In my experience, I was having constant diarrhea, especially right after eating.  So, if I was at work, I couldn't eat.  I lost over 30 pounds.  Not much gallbladder pain, but I did have nausea, especially in the morning. No vomiting.

      They did a colonoscopy and endoscopy.  I had two colon polyps, noncancerous.  Essentially, the tests were "normal."  

      I was initially diagnosed with IBS-D, which is really a non-specific diagnosis.

      I had ultrasounds, which didn't show many stones, but the issue for the doctors was that I wasn't presenting the classic symptoms.  I realized that in order to get treatment I was going to need to tell them I was experiencing a lot of pain, so I did.

      When my gallbladder was finally removed, it was brimming with sludge and small stones.  I wish I could say that I was one of the lucky ones who had no symptoms after that.  But even before my surgery, I had bile acid malobsorption.  My system can't reabsorb the bile secreted during digestion.  So I'm on medication for that, which I've taken daily since 2009.

      So, you're correct.  Nothing obvious enough to tempt them to do surgery, but I was still sick!  

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    • Posted

      I have heard that gallbladder problems can be hard to diagnose and you are proof of this!!!!  It must have been awful for you, were you in pain with the diarrhea, ie: burning due to the bile?  It's a good job you ahd the sense to tell them you were in pain or you would still be in the same boat now!!!

      Does the medication work for you or do you still suffer?

      I will ask him about the panel check, did you have this done eventually and did it highlight your problems?

      It sounds like you've been though hell, I hope things are better for you now.

      Many thanks for all your advice, I really appreciate it.

      Bernie

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    • Posted

      Hi Bernie,

      The blood test will show if your enzyme levels are elevated, which can be a sign of stress.  Mine were slightly elevated, but it's part of the whole picture, that, and the bile and the presence of stones.  

      Yes, it was tough.  I had just started a new job, and my father-in-law had been diagnosed with lung cancer.  My husband and I travelled by air to see him and the family in July.  The day we arrived, I hadn't had anything to eat--just water, and I was in constant fear of soiling myself.  That night, I had a small dinner in the hotel restaurant and was sick immediately afterwards.

      My husband took me to an Urgent Care facility, and I ended up seeing a gastroenterologist, but I was confined to the hotel room for most of the time we were there. That's when the first set of stool tests were run and came back "normal."  I think I got to see the family twice.  Then, it was back home and I had to run, after my husband, past 63 gates in the Denver airport to make our final flight.

      The gastro guy here insisted on a colonoscopy and endoscopy.  More "normal" stool tests. That's when I started exaggerating my pain.  I saw a surgeon who told me, "I've been fooled by ultrasounds before."  So he agreed to take my gallbladder out.It was strange to be in the hospital, waiting to be called in for surgery.  I was scared, but so happy! The other people around me didn't have the same outlook I did.  

      The bile was extremely painful.  It felt as though my rectum was being eaten away. (Sorry for being so graphic, but I think it's why we talk to each other on this site.  We can tell each other the truth.)

      The medication helps, but I have to be very careful, and eat low fat.  Sometimes, I have to take immodium, just in case.  Things are better, now.  I learned a lot from going through this!

      So, now, I have to ask you.  How did you end up with an ileostomy?  You don't have to answer if you'd rather not!

      Lynda

       

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    • Posted

      Oh Lynda, what a nighmare!!!  You must have been so worried, with doctors telling you they could not find anything and knowing deep down there was something very wrong!!!  And to top it all your father-in-law being so ill!!!!

      I so understand the fear of not making it to the toilet, I had Ulcerative Colitis for 20 years before my colectomy and the panic involved when you get the urge to go is awful.  I have no problem talking about it, I found a great forum which helped me make the decision to go for an ileostomy...it was a pretty scary decision but one I still don't regret, but my pouch works perfectly it's just this rectum problem.  I have had ulcerated hemorrhoids, in and outside of the anus along with ulcerated skin tags.

      It's only now that I realised oily yellow diarrhea may be down to something else, I and my consultant were only concentrating on the pouch and associated problems. That is how my rear end feels, as though someone is sticking burning needles in me and it just doesn't stop, especially if I eat anything rich...which I try not to!!!

      So would you say you are pleased you had your gallbladder removed even though you obviously still have digestive problems?  Have you tried psyllium husk by the wa? I use this and immodium as a pouch does not absorb liquid so it helps to thicken stool.

       

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    • Posted

      Bernie, thanks for listening to my story.  At first, I was worried, then I got mad. When I saw the surgeon, his associate told me that the body measures out the same amount of bile, every time, during digestion.  Her assertion was beyond ridiculous!  When I heard this, I was really afraid that the surgeon wouldn't be willing to take it out.  Instead, he did.

      I can honestly say, I'm glad had my gallbladder removed.  I haven't tried psyllium husk, but I might in the future.

      Perhaps part of the problem with your rectum is the fact that bile keeps flowing over the already damaged tissues. The resin that I take absorbs the bile effectively, so I have almost no irritation, the burning needles sensation.  The medication originated to absorb cholesterol and is usually prescribed by doctors for people with bile acid malobsorption, like me.

      I hope all this has helped you!  Please let me know how your appointment goes!  Take care!

      Lynda   

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    • Posted

      That's the trouble with doctors, they look for the obvious and not outside of the box...you're lucky your surgeon went ahead and removed it..although I doubt you would have accepted a no!!!

      I will let you know how it goes on Thursday..though if I have my gallbladder removed I won't have much left in there smile

      You've been such a help, I understand how the gallbladder works now so will at least know what I am talking about!!!

      Cheers

      Bernie

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    • Posted

      Hi there,

      Well, if it is your gallbladder then it's best to get it out, though I have the feeling that you're concerned that you're going have a heck of an echo in there!  

      I'm sure that your liver will still be good company for your pancreas, though!  smile 

      If the surgeon had told me "no" I would probably have burst into tears, fallen to my knees and begged!  

      I'm glad I've been of help.

      Please do let me know...

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    • Posted

      Do you think it's likely to be my gallbladder then if it's showuing sludge on the ultrasound and the fact that my backside is on fire!!!

      Ha ha..it will and I still have my duodenum (nearly lost it as it was stuck to my colon) so I'll have a trio of organs left biggrin

      It gets like that when you are in so much pain for so long...I welled up when I asked my GI to remove my colon and he tried to persuade me to try more drugs...I said I'd had enough and he jumped up, grabbed a tissue and said ok no problem I'll refer you to the surgeon !!!

      I'm so pleased you got your life back..or more or less.

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    • Posted

      I do think it's likely to be your gallbladder. Doesn't matter if it's filled with stones, or sludge--if it's not working, it's not working.  Bile is one of the most caustic substances I know of--I still haven't forgotten what it did to my backside!  smile

      I'm hoping that the doctor will be willing to check out whether it's gallbladder disease or not--he sounds like a good guy!

      Let me know how it goes...

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    • Posted

      Yeah, he's a good guy...I've been seeing him on and off for 4 years now, so he knows me well, and I'm sure he'd rather remove my gallbladder than his pouch!!!

       

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    • Posted

      If you've been seeing him so long, after all that you've gone through, I'm sure he'll listen to your thoughts, and be happy to get those tests done!

      Let me know how things go on Thursday, okay?

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    • Posted

      Well, I am having my gallbladder removed next Thursday....he said it was full of sludge and even if I didn't have the other symptoms it would have to go.

      All the worry about what the problem was and I feel total relief to be getting it removed...I know exactly what you mean now Lynda!

      His secreatary said it is day surgery providing he can do it keyhole (he said he may have problems due to all the surgery I've had) Do you remember how long the recovery is and how long before you can drive?

      I have a ream of new questions now...sorry!!!!

      I am so pleased I found this forum and you have been amazing Lynda...thank you so much.

      x

       

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    • Posted

      Hi Bernie!

      I'm so pleased for you!  I hope that this will help sort out what you've been going through!  

      Even though nowadays the surgery is relatively simple, that is, the keyhole surgery, it's still considered major surgery.  The outside stitches will heal in 5-6 weeks if all goes well.  It took me more than six months to get some stamina back.  Longer, for me to feel "normal" but that could have been a function of the bile acid malobsorption.  

      Your doctor will give you instructions, but I suggest you check with your insurance company to see if it has any driving restrictions on your policy.

      Is your doctor familiar with the resin prescribed for bile acid malobsorption?  If you'll private message me, I'll tell you the name.  I think that some type of bile absorbing medication will be necessary to stop the bile acid "bath" you've been experiencing.  

      I am so glad to have been of help to you!  Please keep in touch, and let me know how you get on!

      (((BIG HUG)))

      Lynda

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    • Posted

      Hopefuly it will be keyhole, he always warns me it could go open, but touch wood, as of yet he's done all my ops keyhole.

      That's a good shout about checking with the insurance, I'll do that.

      I'll drop you a pm for the name of the resin medication, thanks.

      I will of course let you know how it goes and will post my experience as well in case it will help anyone else.

      Thanks so much Lynda...it means so much to have some support when you are going through this, nothing is set in stone with gallbladders is it!!!!

      Roll on next Thursday eek

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    • Posted

      Hi,

      My op that was scheduled for today has been postponed as my pre op bloods showed I am critically anemic, my hb is 4.8 and I am now in hospital having 3 units of blood!!!  Looks like the gallbladder removal is on a back burner until they find out what is casuing the anemia frown

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    • Posted

      I'm so sorry to learn about this!  I hope they find out what's going on soon!  

      In the mean time, please know that I'm thinking of you--and do let me know how you're getting on!

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